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Acetabular version and long posterior wall cup in total hip replacement.

P Chandran1, M Azzabi, A Lister

  • 1Department of Trauma and Orthopaedics, Scarborough General Hospital, Scarborough, UK. prakachandran@yahoo.co.uk

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|July 23, 2008
PubMed
Summary

Understanding acetabular anteversion is crucial for long posterior wall cup placement. Different anteversion types significantly alter the cup

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Acetabular anteversion definitions (operative, anatomic, radiographic) lack clarity.
  • This ambiguity impacts the optimal positioning of long posterior wall (LPW) cups in hip arthroplasty.
  • Understanding these definitions is critical for surgical success.

Purpose of the Study:

  • To define and differentiate operative, anatomic, and radiographic acetabular anteversion.
  • To investigate the effect of these anteversion types on the position of a long posterior wall (LPW) cup.
  • To propose simplified terminology for surgical relevance.

Main Methods:

  • Cadaveric study modeling acetabular anteversion using radiographic techniques.
  • Utilized a Charnley double wire marker for LPW cup placement.

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  • Correlated anteversion angles with computer-generated line diagrams of the acetabular cup.

    • Main Results:

    • The position of the LPW varies significantly with different anteversion angles.
    • Increasing operative anteversion causes the LPW to shift inferiorly, negating its intended benefit.
    • Radiographic and anatomic anteversion also influence LPW positioning.

    Conclusions:

    • The proposed simplified terms (flexion-anteversion, internal rotation-anteversion, combined anteversion) aim to clarify surgical application.
    • Surgeons must understand the impact of each anteversion type on LPW cup positioning.
    • Accurate assessment of acetabular anteversion is essential for maximizing the benefits of LPW cup design.